CMS Price Transparency Data

CT scan, sinuses

Facility: Metrohealth System

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $178
Cash Discount Price: $300
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Metrohealth System is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $300. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.67x the Medicare baseline. Located in 2500 Metrohealth Drive, Cleveland, OH.

Cash / Self-Pay

$300

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $300 (281%)

Insurance Median: $178 (167%)

Cash: $300 (281% of Medicare)

Ins. Median: $178 (167% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medical Mutual	$54 - $393	51%
Humana	$86	81%
Aarp	$99	93%
Valor Health	$100	94%
Perennial Advantage	$101	95%
Mcgregor Pace	$109	102%
Buckeye Health Plan	$129	121%
Caresource	$138	129%
Aetna	$158 - $235	148%
Health E Ohio	$208	195%
Blue Cross Blue Shield	$215 - $377	201%
UnitedHealthcare	$236	221%
Clarity Health	$257	241%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $300.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70486.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Metrohealth System is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70486.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.